10 Questions: Michael R. Jaff, DO

'If we dont do something, U.S. will no longer be world's best healthcare system.'

Michael Ritt Jaff, DO, is medical director of the Fireman Vascular Center and of the Center for Specialized Services at Massachusetts General Hospital in Boston.

Jaff founded VasCore, the Vascular Ultrasound Core Laboratory, and serves as its medical director. He was also instrumental in starting the American Board of Vascular Medicine for certification of vascular medicine physicians and is active as a trustee of the Society of Cardiovascular Angiography and Interventions.

1. What's the biggest barrier to practicing medicine today?

My list is so long ... I would have to say the biggest barrier to practicing medicine would be the burden of documentation that's placed on the physician. It doesn't keep us from practicing medicine but it certainly eats up so much time out of the day that it threatens our ability to spend as much time with patients as we would like.

2. What is your most vivid memory involving a patient who could not afford to pay for healthcare (or meds, tests, etc.) and how did you respond?

I'm actually right now involved with one of my patients who could very well turn out to be one of my most vivid memories. This is a lovely gentleman who has come upon incredibly difficult times in his personal and business life and is in the middle of trying to find some sort of healthcare coverage. He's trying to work out the new healthcare mandate for insurance coverage in Massachusetts. He needs a series of things done because he's very sick. We used to do things like hand out samples of drugs but now we're not allowed to do that anymore. It's very difficult to streamline mainly prescriptions for someone who has no money. What I'm doing is trying to keep this guy alive until he figures out how he can afford to do what definitively needs to be done. It's a very sad and frustrating situation for me and my staff. We call him all the time to make sure he's okay. We're constantly speaking with our finance office to see if we can facilitate things and develop a payment plan. It's been very challenging and he's a fantastic guy.

3. What do you most often wish you could say to patients, but don't?

That if we don't do something the U.S. will no longer be the most sophisticated healthcare system in the world. I would love to be able to say that to people.

4. If you could change or eliminate something about the healthcare system, what would it be?

From a patient's perspective I would make it easier to navigate. In other words, I would make it easier for patients to know which doctors are best doctors for them to see for their particular problem. From a physician's perspective, I would reduce the administrative burden of the entire healthcare system not only from the documentation aspect, but pre-approval through insurance, how to transfer somebody to an extended care facility for post-acute care -- the burden of administrative bureaucracy that plagues the system.

5. What is the most important piece of advice for healthcare providers just starting out today?

Make sure you're doing it because you love the concept of being a doctor. If you go into this for any other reason you're going to be sorely disappointed. But if you really love the concept of providing care to someone who is sick and making them better, there is no better job to have.

6. What is your "elevator" pitch to persuade someone to pursue a career in medicine?

There's nothing that feels better than when a patient who comes to you sick and scared after you treat them hugs you and sends you cards and calls you to see how you're doing. It's the best feeling in the world.

7. What is the most rewarding aspect of being a healthcare provider?

It's making people feel better. I know it sounds like a corny line but still to this day just knowing that people come to me in their most dire of situations and at the end of the day they know that I've done my best. It's incredibly rewarding.

8. What is the most memorable research published since you became a physician and why?

The most memorable research was actually the fact that you could treat blood vessel disease without an open operation, so really back to the days of Gruentzig.

Refocus why they became a doctor in the first place. So whatever was that burning desire to actually go through the process of getting into medical school, fighting your way through medical school, the long hours as a resident and a fellow -- refocus on what gave you that flaming desire to do it and try and recapture that.

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